Should cost-effectiveness analysis include the cost of consumption activities? An empirical investigation

C. Adarkwah, A. Sadoghi, A. Gandjour

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

There has been a debate on whether cost-effectiveness analysis should consider the cost of consumption and leisure time activities when using the quality-adjusted life year as a measure of health outcome under a societal perspective. The purpose of this study was to investigate whether the effects of ill health on consumptive activities are spontaneously considered in a health state valuation exercise and how much this matters. The survey enrolled patients with inflammatory bowel disease in Germany (n=104). Patients were randomized to explicit and no explicit instruction for the consideration of consumption and leisure effects in a time trade-off (TTO) exercise. Explicit instruction to consider non-health-related utility in TTO exercises did not influence TTO scores. However, spontaneous consideration of non-health-related utility in patients without explicit instruction (60% of respondents) led to significantly lower TTO scores. Results suggest an inclusion of consumption costs in the numerator of the cost-effectiveness ratio, at least for those respondents who spontaneously consider non-health-related utility from treatment. Results also suggest that exercises eliciting health valuations from the general public may include a description of the impact of disease on consumptive activities. 

Original languageEnglish
Pages (from-to)249-256
Number of pages8
JournalHealth Economics
Volume25
Issue number2
Early online date15 Feb 2015
DOIs
Publication statusPublished - Feb 2016

Keywords

  • consumption
  • Crohn's disease
  • leisure time
  • quality-adjusted life year
  • time trade-off
  • ulcerative colitis
  • validation study
  • INFLAMMATORY-BOWEL-DISEASE
  • HEALTH-STATE VALUATIONS
  • QUALITY-OF-LIFE
  • POPULATION PREFERENCES
  • CALCULATING QALYS
  • FUTURE COSTS
  • SILENCE
  • PATIENT
  • LEISURE
  • INCOME

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